I wouldn't be comfortable with that answer either, especially if he has acted the same for the last two years. Hepatic encephalopathy usually comes and goes (depending on how the liver is processing things). I wold be concerned about the unresponsiveness.
What food was he on for the last two years and what are the ingredients of the homecooked diet including supplements?
What is the lactulose dose and how many times a day?
Metro is used extensively with LS, but problems are't unheard of...
Could you go to Cornell for a consult? They are the LS experts in NY and probably the safest place to have surgery done there...
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